Asking patients at a hematology/oncology clinic to complete a review of systems (ROS) checklist not only identified those experiencing distress but also increased the accuracy of provider notes, according to a poster abstract presented at the Association of VA Hematology/Oncology (AVAHO) Annual Meeting. 

“Distress in cancer patients is common and … can negatively affect the ability to cope with cancer diagnosis, symptoms, and subsequent treatments. Ideally, patients would be screened at every visit to identify the level and nature of distress,” wrote presenter Laura Stanko, MD. 

The 2-week study involved 178 patients who completed a ROS/distress screening form before a visit at the hematology/oncology clinic at the Veterans Affairs Medical Center in Gainesville, Florida. Patients checked off symptoms they were experiencing and rated their distress level on a scale of 0 to 10. During the first week of the study, forms were collected but not shared with providers. During the second week, providers were handed the responses during patient visits. 

When ROS responses were compared to provider documentation, the study found accuracy increased from 13.02% during week one (when providers did not have access to ROS forms) to 27.74% in week two (when they received ROS forms during visits).  

Among 178 patients who filled out the ROS form, 50 patients indicated they were experiencing moderate to high distress. All were referred to social work for further evaluation.

“Implementation of a ROS/distress screening form increased the accuracy of clinical documentation as well as helped to identify patients experiencing distress,” the abstract explained, “resulting in earlier interventions with referrals to social work, mental health, and/or chaplaincy services.”

Reference:

Stanko L. Improving clinical documentation and distress intervention: implementation of distress screening and review of systems checklists at the Gainesville VAMC Hematology/Oncology Clinic. Abstract presented at Association of VA Hematology/Oncology (AVAHO) Annual Meeting; September 24-26, 2021.